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Neuropathy by definition is a disease or dysfunction of one or more peripheral nerves causing symptoms of numbness, pain, weakness or all three. In the diabetic patient neuropathy symptoms present distally (away from the heart) first, moving proximally (towards the heart) as the disease progresses. It also tends to be symmetrical, meaning symptoms are the same on both the left and right sides of the body. Diagnosis of neuropathy often comes late in its progression due to ignorance by patients. Patients are unaware of the symptoms they should be on the lookout for and they do not frequently visit a Podiatrist, who monitors neuropathy and risk factors for the disease.

In order to catch neuropathy early on, there are some risk factors you should be looking for and steps you should be taking to prevent development or slow progression:
1. Control your blood sugar – Diabetic neuropathy is directly correlated to poor sugar control. As the levels of glucose rise in the blood stream the chance of causing injury to the nerves increases, thus the chance of developing neuropathy also increases. Keeping your glucose levels controlled maintains an appropriate level of glucose in the blood stream decreasing the sugars opportunity to affect the peripheral nerves.
2. Visit your Podiatrist regularly – Typically, in diabetic patients with no complications (meaning no peripheral vascular disease or neuropathy) you should be visiting your Podiatrist every six months. They will evaluate you for changes in light and sharp touch, vibratory sensation, ulceration risk and deep tendon reflexes. Changes in any of these categories could be your first indicator for oncoming diabetic neuropathy.
3. Stop smoking – Studies have shown that in patients who are diabetic and smoke, their risk for diabetic neuropathy greatly increases. Cutting back and eliminating cigarettes from your life will decrease your risk.
4. Control your blood pressure and your cholesterol levels – Although cholesterol and blood pressure do not directly relate to diabetic neuropathy, they do enhance your diabetes which can in turn, increase your risks. Make sure that you are checking in with your primary care physician regularly and that your blood levels are within normal ranges or that you are taking medications prescribed to you in order to control these risk factors
5. Be on the lookout for – Tingling or burning sensations as well as insensitivity to pain or temperature changes that are new and equal on both sides of the body. For example if you have having tingling on the bottom surfaces of both the right and left foot, be skeptical and schedule an appointment with your podiatrist as soon as possible.
6. Protect your feet – Wearing shoes that are supportive and comfortable decrease your risk of ulceration, a complication frequently associated with neuropathy. Ulcerations in the diabetic patient are a bit trickier than those in a non-diabetic individual, in that they become more frequently infected and have increased difficulty in healing. The best option is to prevent ulceration with protective shoe wear!

If you have been diagnosed with diabetic neuropathy already, you still should adhere to the above-mentioned preventative measures. Diabetic neuropathy is one form of neuropathy that can be reversed to a certain extent, with better sugar control and a decrease in risk factors. Make sure to consult with your Primary Care Physician and your Podiatrist frequently for monitoring and take control of your own destiny! You play as much a role in decreasing your risk of neuropathy as the disease plays in affecting you.